营养支持治疗对老年肺癌合并呼吸衰竭患者的疗效

Efficacy of nutrition support in the treatment of elderly lung cancer patients with respiratory failure

目的探讨营养支持治疗对老年肺癌合并呼吸衰竭患者的疗效。方法选取2013年12月至2014年6月间四川省彭州市人民医院收治的140例老年肺癌合并呼吸衰竭患者,按照数字随机表法分为观察组和对照组,每组70例。观察组患者接受肠内营养支持治疗,对照组患者采用静脉营养进行支持。观察两组患者相关营养指标变化、病死率和不良反应发生率等,并对相关数据进行分析。结果治疗后,两组患者血红蛋白、白蛋白和前白蛋白指标显著优于治疗前,差异均有统计学意义(P<0.05),且观察组患者治疗后血红蛋白、白蛋白和前白蛋白指标改善显著优于对照组,差异均有统计学意义(P<0.05)。观察组患者治疗后体重指数(BMI)、上臂中部皮褶厚度(MAC)和肱三头肌皮褶厚度(TSF)改善情况显著优于对照组,差异有统计学意义(P<0.05)。随访1年后,观察组患者低蛋白血症发生率、肺部感染发生率和病死率分别为2.9%、4.3%和1.4%,均显著低于对照组的12.9%、18.6%和8.6%,差异均有统计学意义(均P<0.05)。结论合适的营养支持对老年肺癌合并呼吸衰竭患者疗效显著,可提高治疗的综合效果,降低病死率,值得临床进一步研究。

Objective To discuss the efficacy of nutrition support in the treatment of elderly lung cancer patients with respiratory failure. Methods From December 2012 to June 2014 in Pengzhou People＇s Hospital, 140 patients were enrolled in the study and randomly divided into the observation group and the control group, with 70 cases in each group. The patients in the observation group accepted enteral nutrition support and those in the control group accepted intravenous nutrition support. Nutrition indicators related changes, mortality and adverse reactions incidence were observed. Results Compared with before treatment, after treatment, hemoglobin, albumin and pre-albumin index were significantly better, with significant differences （ P 〈 0.05 ）, and the observation group was significantly better than that of the control group （P 〈 0. 05）. The body mass index （BMI）, mid upper arm skinfold thickness （MAC）, triceps skinfold （TSF） of the observation group improved significantly better than the control group （P 〈0. 05）. After 1 year of follow-up, hypoalbuminemia, lung infection incidence and mortality of the observation group were 2. 9%, 4. 3% and 1.4%, significantly lower than 12. 9%, 18.6%, 8.6% in the control group （ P 〈 0. 05 ）. Conclusion Appropriate nutritional support for elderly lung cancer patients with respiratory failure could achieve significant efficacy, improve the overall effectiveness, and reduces mortality. And it is worthy of further study.